Due to rapid population aging and more frequent and heavier drinking among the baby boom generation, an alarming rise is expected in the number of older adults with alcohol-related problems. At the same time, more than 50% of adults over age 55 in the U.S. have hypertension (HTN) and cardiovascular disease (CVD) remains the nation's leading cause of death. Alcohol use is strongly related to HTN and CVD, and moderation of alcohol is key for preventing and managing HTN in older adults. Although low levels of alcohol use can have cardioprotective effects, physiological changes, chronic illnesses, and medication use can make even small amounts of alcohol detrimental for cardiovascular health among older individuals. Marriage is a critical context for examining alcohol use and its effects on cardiovascular health. Over 60% of older adults are married and couples often engage in similar (i.e., concordant) drinking behaviors that can benefit marital quality, potentially establishing or maintaining problematic drinking patterns. Further, it is well established that CVDs and their biological risk factors are moderately to highly heritable, indicating that they are influenced by genetics. However, we know little about how alcohol use changes among couples as they age together or the marital and genetic factors that may make individuals and couples more resilient or vulnerable to CVD. In response to Accelerating the Pace of Drug Abuse Research Using Existing Data (PAR-16-234), the proposed project will use nationally representative longitudinal data from one of the largest studies of older couples (N = 8,545 married/cohabiting couples; 17,090 individuals) to address the following aims: 1) Identify alcohol use patterns among older couples over time and the demographic and contextual predictors of those patterns, 2) Determine the implications of individual and partner alcohol use for cardiovascular health and mortality among older couples over time, 3) Identify genetic and marital risk and protective factors linked to alcohol-related cardiovascular health and mortality among older couples, and 4) Develop and validate an innovative prognostic model to identify individuals and couples at high risk for poor cardiovascular health and mortality. Identifying individuals and couples who are most at risk or resilient to alcohol-related cardiovascular health problems and development of new prognostic models will generate key insights for designing and testing interventions to reduce these major public health threats among the growing population of aging adults.